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In recent years, the prevalence of diabetes has continued to rise, with about 536.
6 million people diagnosed with diabetes
.
It is estimated that at least 783.
2 million adults worldwide will be affected
by diabetes by 2045.
The aim of this study was to evaluate the cardiovascular and renal benefits
of pheneridone, a non-steroidal selective mineralocorticoid receptor antagonist, sodium-glucose cotransporter-2 inhibitor (SGLT2i), and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in patients with type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD).
The researchers systematically searched the PubMed, Cochrane Library, Web of Science, Medline, and Embase websites for randomised controlled trials
comparing phenilidone, SGLT-2i, and GLP-1 RA treatment in people with diabetes complicated by CKD.
The effects
of the two drugs were indirectly compared with pheneridone through a network meta-analysis.
Risk effects of various drugs compared to MACE
Eighteen randomised controlled trials with a total of 51,496 patients
were included.
Pheneridone reduced the risk of major adverse cardiovascular events (MACE), renal prognosis, and heart failure hospitalization (HHF) (RR 0.
88, 0.
86, and 0.
79, respectively).
SGLT-2i was associated
with a reduced risk of MACE (RR 0.
84), renal prognosis (RR 0.
67), HHF (RR 0.
60), all-cause death (ACD, RR 0.
89), and cardiovascular death (RR 0.
86) compared with placebo.
GLP-1 RA was associated with a lower risk of MACE (RR 0.
86).
SGLT2i has significant benefits in renal prognosis and HHF prognosis compared with phenirenone and GLP-1 RA (phenirenone vs SGLT2i: RR 1.
29 and 1.
31; GLP-1 RA vs SGLT2i: RR 1.
36 and 1.
49).
Risk effects of various drugs compared to renal prognosis
In summary, SGLT2i, GLP-1 RA and noneridone were comparable in MACE, ACD, and CVD
in T2DM patients with CKD.
SGLT2i significantly reduces the risk of
renal events and HHF in patients with T2DM with CKD compared with pheninone and GLP-1 RA.
Original source:
Zhang, Y.
, Jiang, L.
, Wang, J.
et al.
Network meta-analysis on the effects of finerenone versus SGLT2 inhibitors and GLP-1 receptor agonists on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus and chronic kidney disease.
Cardiovasc Diabetol 21, 232 (2022).
https://doi.
org/10.
1186/s12933-022-01676-5
